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HomeMy WebLinkAbout05-09-11t ~ 15056051047 REV-15 0 0 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes f INHERITANCE TAX RETURN h PO BOX 280601 ~ ~ ~ ~ V~.1 G G Harrisburg, PA 17128-0601 µ~ RESIDENT DECEDENT ~} o ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth Decedent's Last Name Suffix Decedent's First Name MI mgElu~~- ~2 ~~D`12~~ ~ (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUP!_ICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O <t. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) O 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust f{. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX (INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number Firm Name (If Applicable) First line of address Second line of address City or Post Office State ZIP Code L "~' ` Correspondent's a-mail address: .~7 t::~ r , ,:_'> - ,-.~, -; .: -~ -; `mot ,., '~~ Un ties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, i '"s true, co rect and comple . Declara n of preparer other than the personal representative is based on all information of which preparer has any knowledge. S ATU OF PER ON RE N LE FOR FILING RETURN DATE ~1u~~1~,~ZortS A D _ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 15056051047 1,5056051047 J~ J 15056052048 ~ y REV-1500 EX Decedent's Social Security Number Decedent's Name: ~ ( ~ '~.,,(~ % 1 ~-~ ter' ~P RECAPITULATION 1. Real estate (Schedule A) . ......................................... ... 1. ~ ~ ~ ._ 2. Stocks and Bonds (Schedule B) ..................................... .. 2. - ~ -" 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. `"'"-"f~ ~ "-'' 4. Mortgages & Notes Receivable (Schedule D) ........................... .. 4. -~-~ ~-T 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ...... .. 5. ~ 2. ~'j ~~ ~ G 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ..... .. 6. ~ - d ~' 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O Separate Billing Requested...... .. 7, r---~ '-' 8. Total Gross Assets (total Lines 1-7) .................................. .. 8. L~ .Z ~'j S^. O Q 9. Funeral Expenses & Administrative Costs (Schedule H) ............. ........ 9. ~ ~ (d ~' ~' ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........ ........ 10. •- ~ 11. Total Deductions (total Lines 9 & 10) ............ . .............. ........ 11. '~ ~ Gi ~ ~ ~ ~ 12. Net Value of Estate (Line 8 minus Line 11) ...................... ........ 12. 'Z.. Z,. ~ ~~ 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................ ........ 13. ~ '-` 14. Net Value Subject to Tax (Line 12 minus Line 13) 14. ~' ~ ~ ~ ~ TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable ~ at lineal rate X .0 - • 16. ~„ 2 ~? © ~ 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable ~ at collateral rate X .15 18 19. TAX DUE .........................................................19. ~ 6 ,~ / 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056052048 15056052048 O J REV-1500 EX Page 3 File Number ~~ ~ ~ ~ ~ ~^ - s r Decedent's Complete Address: DECEDENT'S NAME STREET ADDRESS CITY C~~s ~~ ~ STATE Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 2. CreditslPayments A. Spousal Poverty Credit `- ~ '"~ __ B. Prior Payments ~ __ C. Discount p _ Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest r-- ~ - E. Penalty ~ ,. r-- Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (5) (5A) ~o . ~.t .. ®-. ----- ~ o - ~~ ~~ _ B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~~ ~~ Make Check Payable to: REGISTER OF WILLS, AIGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :.......................................................................................... ^ .Q b. retain the right to designate who shall use the property transferred or its income : ............................................ ^ 0 c. retain a reversionary interest; or .......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. ^ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for th~a use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent (72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percen1C [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1511 EX+ i 10-06) ~`O,ri,Y ` ~' ~~~~'~ CNEDULE ~1 COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT FILE NUMBER ESTATE OF ~_~~ ~°~ t"., L~ ./I'7~-~-r~ u FSL. ,,~'~ _- Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: ~.~ ~- ~~y~, ~~ { ~ ~~~ ~ ~ ~ ~ } ~ ~,-. 1. B. ~ ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) ~~~~ ~ ~t,~ ~-'Lp. Street Address ___~ ~-~"' -11..I -~- - f --- - _-_ - ' np, - City ~ i.,a'E~ State Zip !- ~ C~.~ 3---_-. _.._. Year(s) Commission Paid: -- 2• Attorney Fees 3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant -~ C~. Street Address City State Zi P - ----- .- __- ___ __ Relationship of Claimant to Decedent 4. Probate Fees . _.. V 5~ Accountant's Fees ~--- ~ ~-~- 6. Tax Return Preparer's Fees ---- ~ --- 7. TOTAL (Also enter on line 9, Recapitulation} ~ ~ (It more space is rceded, insert ;3dflition-~I sleets ni fhe same size} ~-- .(`~(~ ~~ ~ ,.; -_ ~, ~, P' riEV-1508 EX . ,1-9i) ~.~ SCHEDULE E .j; . COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, a MASC. ~~HRESIDENT DECEDENT RN PERSONAL PROPERTY ESTATE OF FILE NUMBER include the proceeds of litigation and the date the proceeds were received by the estate. All property jointty-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. -~ s~ r~ r~ ~. (~ C. Gam, t..9 ~ ~ 1 } r "Z~ a .. ~.,~ TOTAL (Also enter on line ti, Recapitulation) $~tT~~- ~"' ~ ~_ (if )7~cre space is nz~edetl, insert adciitiona( sheets of the same size) QRRSTOWNBANI~ :-~ Tradition of Excellence ORRS P.O. Box 250 Shippensburg, PA 17257 Temp-Return Service Requested Date 9/30/09 Page 1 Primary Account 108007019 Enclosures 000214 0.4500 AV 0.335 TR00001 '~ George W Manuel Sr Estate George W Manuel Jr Ex ~_ 465 N Pitt St Carlisle PA 17013-1946 Building? Buying? Remodeling? We can help! 1.888.ORRSTOWN - orrstown.com C H E C K I N G A C C O U N T S Account Title George W Manuel Sr Estate George W Manuel Jr Ex Free Checking Check Safekeeping Account Number 108UUi01y Statement Dates 9/22%09 thru 9/30/09 Previous Balance .00 Days In The StatE~ment Period 9 1 Deposits/Credits 4,295.05 Rverage Ledger .00 2 Checks/Debits 4,295.05 Average Collected .00 Service Fee .00 Interest Paid .00 Current Balance .00 0 N ~ Deposits and Additions c Date Description Amount °0 9/22 Deposit 4,295.,05 N O O 01 O °o --- CHECK SUMMARY --- e Date Check No Amount Date Check No Amou nt ° 0 9/22 101 400.00 9/22 202* 3,895.05 * Denotes missing check numbers N O O Ln O tC ~~ e--1 ~ O O~ N ~ Daily Balance Informati on ~ ° Date Balance ° ~ 9/22 .00 THANK YOU FOR BANKING WITH ORRSTOWN BANK _ y z _ `~ i~ ~^1 0 /~ m c'-~ ~ O YI D ~ Y~ 2~ U~ ~ m Z r' - ~~ m = m ~ ~ I m`yo t ff__.~ -°~°'~ Vv p ~ ~~ v ~ ~ o ~, m n~ M n~~ ~! ~ ~ m= D IG m n ~ ~ ~ n n ..,.~ D a I m - nr G ~ m m =_ ~ i ~ xa;Vl m i IC ~s = , ~ m m :~; 0 C^Y o m ~ ° V ' ° C j I ~' ~..~ o c A ~ ~ - ! Nm I. d N ~ ! ~ ~ ~ ~ I ~ _~ ~ O MoD y m=~ O ~ H ~rn W o ~ ~ m0 r ~ W n j~ ~ r to ,,.~ r ~ ~ o of ~ ~ ~ r ~ ~~. .~ = i ~\ r 1 ~- m ~_ c~ o ~ o _ r ~ - D I _ ~ _ ~ ~ o, ~o -_ ~ u, ° ~ ~ ~ C= S ^_~ n v D O nT O ~' , ° ~o ~ ~, = v ~^ m ~, m ~ -i mm D ' ~ ~ n ~ C O C f = S m ~ ~ ~ n ~i m x ~ ° m n ti ~, ~ ~ z c < ~~ a m O ° G /` - Y' ~ ~ ~ N I ~' O _ ~ ~ 7~o O p ~ ~. rn -I •< .• _ ~ ~ O (" o~m W w ~z ~ .-. ~ ~ ^ ~ x~ ~ ~~ ~ ~~ .. r /~ o ~ ~ ~ ,' ~ iQ o ~ ~~ ! 1`1 ~ ,~ ~ ,~ o ;~ ~_ a ,~ ~ c ~ ) 9i C ID - ~ IT p ~~ ~~ t~ ~~ ~ - m ~-~ ~ ~~ - ~ ~ o o ~ '~ D ]7 ~ ~ ~ ~ ~ _ ~ ~~ Q w cn '~ !~ ~ ~ 0 i I I~ I Chk Qty Document Fee Ea Charged - Letter of Adm or Test (circle one) ~ ~ . G'~L'> - Estate Information Sheen n/c Photo ID n/c Will -Dated 15.00 - Copy of Will n/c - Codicil -Dated 15.00 Death Certificate n/c - Township n/c - Renunciation , 5.00 f ~ , (;~ - Short Certificates 4.00 - Bond (Waived or PA Resident) 15.00 Atty Signature n/c - JCP Fee 10.00 ' 10.00 - Automation Fee 5.00 ~.5. '> - Clock Atl Documents TOTAL, Call or Mail to: Probated by: \~[~I W 1 ~~ V V ~~ 1~1~1 V~ ~U313 3 PAY TO THE Hoffman-moth ORDER OF ~~~~~~~~ Three Thousand Eight Hundred Ninety Five and ~~,/it}0 Gorge 4~ Manuel Sr. `' Remitter - ,_ --_------- - ---- „'0 58 3 :5~~' 1:0 3 ~ 3 L 50 361: L0 3 00460 2~~• Maranatha-Carlisle • Financial Management Service • Client Account 28038 #10226 Check number........ 28038 ESTATE OF GEORGE MANUEL, SR. Check date.......... 09/22/09 Check $ amount...... 4,295.05 Fairshare $ deducted 0.00 Fairshare % rate.... 0.0% Payments are tagged "PIF" if our records show the account is Paid In Full. Payment Client Name (last, first) Account Number ----------------- -------------------------- 4295.05 MANUEL, GEORGE BALANCE OF FUNDS DATE ~I~~ ~~~~~~ ~ not ~~ DOLLARS i-' ~-- R 6 MONTHS ^^ LIl r r W ru • ^ r ~] -t ~ - -~7 - ~ r O a A (~ ~O~ ~~ ~~ ~I BD~3 p ov m ~~ ~ ym ~ y -~ a ~ ~ a n o 4 ` ~ ~ ,7"l~ a ~ ~ t~ 3' ~ 1•.,. ti m ~ _~ m DZ m o m '~ Z~ c ~> a 3c Z~ rn mC ~ ~^ ~ . rs ~ ~ ~= ~ ~ '' ~ `~ -~ ~' " a I t? ~~ t pr m *-. + C: ~~ ~ ~~ C'. ~1 C/`\ t~~ ~, G 5 J ~~ ~ C rn ~'' 0 ~' ~N 0 O ~> ~ m ~~ o y 9 ~ ~~ ~~ ~ U) ~ H ~+ y -n t=J ,ca C~J w . O Ci O ~ m. O ~ ~~ ~ m ~ ~ 3 O _` u-' +n 'z~ G~ w x ~ ~ a CI Nod m :ir ~ n ~_ ~ t~rJ H ~ c~° a ® `s w y r ~ f-C C!~ to ~ ~ ~~~ O '~ ~; H mW ? Y - L J ~.'Y • ~ _ r ~, ~7 O ~~-"; Ul r N r O -~ O O D~i~ w ~ ru d ~ -' Q r~~ ~ g .~ ~_~ rD „~ ~y-~ O N -~ `~ rn z a VI-~ C [V 'p W .OOCZ r r ~ ~ O m W D~~ ~ O~Z C 7 . ~ ,. s' C ~< Y Q C 0 ~'"~; '~~ ~ ~- T~ ~ , ~ N '; r., ~ 00 ~ Z O '~-.' ~/2 ~'.. i N v UI r O ~ N ~ ~ ~ ~ W ap ,.~, ;:~~~ , u=:~.~:~ .,~.~..